| NPI | 1538307764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: TX 12008) |
| Additional Taxonomies | 111NR0400X (Licence: AZ 8980) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2021-07-27 |